CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Mercyone Oelwein Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $279
  • Cash Discount Price: $198
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Mercyone Oelwein Medical Center is $279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $198. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.25x the Medicare baseline. Located in 201 Eighth Avenue Se, Oelwein, IA.
Cash / Self-Pay
$198

Average discount available for prompt cash payment at this facility.

Insurance Median
$279

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$223.72

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $223.72 (100%)
Cash / Self-Pay: $198 (89%)
Insurance Median: $279 (125%)
Cash: $198 (89% of Medicare)
Ins. Median: $279 (125% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $223.72 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicare (plans) $116 - $129 52%
Iowa Total Care $118 53%
Medicaid / KanCare $120 54%
Blue Cross Blue Shield $123 55%
UnitedHealthcare $132 - $262 59%
Aetna $143 - $279 64%
Amish Hospital Aid $166 74%
Centivo $187 84%
Ambetter / Centene $209 93%
Health Choices $224 100%
Medical Associates $224 100%
Claimdoc $251 112%
Nova $251 112%
Geha $262 117%
1199 National Benefit Fund $279 125%
Allied Benefit Systems $279 125%
Asr Health Benefits $279 125%
Christian Brother Services $279 125%
Coventry $279 125%
First Health $279 125%
Lucent Health $279 125%
Luminare Health $279 125%
Medical Mutual $279 125%
Meritain $279 125%
Trustmark Small Business Benefits $279 125%
Webtpa $279 125%
Health Partners $292 131%
Multiplan $295 132%
Auxiant $298 133%
Cigna $298 133%
Medica $298 133%
Midlands $298 133%
Midlands Choice $298 133%
Crime Victim Assistance $304 136%
Iowa Dept Of Public Health $304 136%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 Eighth Avenue Se, Oelwein, IA 50662
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals